Emergency pancreaticoduodenectomy in a patient with an ampullary adenocarcinoma associated with severe acute pancreatitis: a case report.

Emergency pancreatico-duodenectomy is an infrequent surgical procedure. Herein, it is reported the case of a 58-year old man with ampullary carcinoma revealed by acute necrotizing pancreatitis. Due to clinical features, an emergency two-step pancreatico-duodenectomy was performed, accomplished by pancreatic and peripancreatic necrosectomy. The distal remnant pancreas was drained as an external pancreatic fistula. A time later, after complete remittance of local inflammation, the pancreas was anastomosed to the jejunum. The postoperative outcome was uneventful, the patient being disease-free at more than 5 years after surgery. Thus, pancreatico-duodenectomy is a feasible and safe operation when performed in tertiary hepato-bilio-pancreatic centers, in selected cases.